Psychiatric Diagnoses and Comorbidities in a Diverse, Multicity Cohort of Young Transgender Women

Reisner, Sari L.; Biello, Katie B.; Hughto, Jaclyn M. White; Kuhns, Lisa M.; Mayer, Kenneth H.; Garofalo, Robert; Mimiaga, Matthew J.

doi:10.1001/jamapediatrics.2016.0067

Cited by 126 publications

(111 citation statements)

References 45 publications

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“…Consistent with clinic and community-based samples, 5–8,44 our representative sample of high school youth in California underscores the high rates of suicidal ideation among transgender youth and identifies depression and victimization as potential mechanisms underlying gender identity-related disparities in suicidal ideation. Therefore, our data underscore the importance of assessing suicidal ideation among transgender youth and also suggest that depression and experiences of victimization may represent critical targets for intervention in clinical practice and care.…”

Section: Discussionsupporting

confidence: 77%

Prevalence and Correlates of Suicidal Ideation Among Transgender Youth in California: Findings From a Representative, Population-Based Sample of High School Students

Perez-Brumer

Day²,

Russell³

et al. 2017

Journal of the American Academy of Child & Adolescent Psych

205

150

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Objective No representative population-based studies of youth in the US exist on gender identity-related disparities in suicidal ideation or on factors that underlie this disparity. To address this, we: (1) examined gender identity-related disparities in the prevalence of suicidal ideation; (2) evaluated whether established psychosocial factors explained these disparities; and (3) identified correlates of suicidal ideation among all youth and stratified by gender identity. Method Data were derived from the 2013–2015 California Healthy Kids Survey (CHKS; N=621,189) and a weighted subsample representative of the Californian student population (Biennial Statewide California Student Survey [CSS; N = 28,856]). Results Prevalence of past 12-month self-reported suicidal ideation was nearly twice as high for transgender compared to non-transgender youth (33.73% versus 18.85%; χ2 = 35.48, p <.001). In fully adjusted models within the representative sample, transgender youth had 2.99 higher odds (95% CI: 2.25, 3.98) of reporting past-year suicidal ideation compared to non-transgender youth. Among transgender youth, only depressive symptoms (AOR: 5.44, 95% CI:1.81, 16.38) and victimization (AOR: 2.66, 95 CI%: 1.26, 5.65) remained significantly associated with higher odds of suicidal ideation in fully adjusted models. In multiple mediation analyses, depression attenuated the association between gender identity and suicidal ideation by 17.95%, and victimization by 14.71%. Conclusion This study uses the first representative population-based sample of youth in the US that includes a measure of gender identity to report on gender identity-related disparities in suicidal ideation and to identify potential mechanisms underlying this disparity in a representative sample.

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Section: Discussionsupporting

confidence: 77%

Prevalence and Correlates of Suicidal Ideation Among Transgender Youth in California: Findings From a Representative, Population-Based Sample of High School Students

Perez-Brumer

Day²,

Russell³

et al. 2017

Journal of the American Academy of Child & Adolescent Psych

205

150

View full text Add to dashboard Cite

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“…More recently, the 2015 US Transgender Survey, the largest assessment of transgender health status and needs to date, found a high prevalence of binge drinking overall, with binge drinking levels much higher in transgender communities of color than in white non-Hispanic peers (James et al, 2016). Those results were congruent with several observational studies with smaller samples of transgender participants that also found a high prevalence of binge drinking (Coulter et al, 2015b; Keuroghlian et al, 2015; Scheim et al, 2016) as well as alcohol use disorder (Keuroghlian et al, 2015; Reisner et al, 2016). We caution that these findings should be interpreted in light of contextual factors.…”

Section: Introductionsupporting

confidence: 91%

“…Across papers, estimates of Alcohol Use Disorders Identification Test (AUDIT) scores indicative of hazardous drinking were fairly stable, at 47%-48% (Herrera et al, 2016; Kerr-Corrêa et al, 2017). Alcohol use disorder was rarely assessed; however, two studies found lifetime and past-year alcohol use disorder prevalence of 26% and 11%, respectively (Blosnich et al, 2017; Reisner et al, 2016). Noting that prevalence of current drinking outcomes varied widely, this may be evidence of high methodological variability across studies, which could impede the development of a coherent evidence base.…”

Section: Review Of Current Researchmentioning

confidence: 99%

Alcohol research with transgender populations: A systematic review and recommendations to strengthen future studies

Gilbert

Pass

Keuroghlian

et al. 2018

Drug and Alcohol Dependence

Self Cite

120

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Given findings that suggest high need for ongoing public health attention, we offer recommendations to improve future alcohol studies with transgender and other gender minority populations, such as being explicit as to whether and how sex and/or gender are operationalized and relevant for the research question, expanding the repertoire of alcohol measures to include those not contingent on sex or gender, testing the psychometric performance of established screening instruments with transgender populations, and shifting from descriptive to analytic study designs.

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“…However, gender dysphoria refers to distress stemming from having a gender identity that is discordant with one's assigned sex at birth, not simply the experience of being transgender. Additionally, transgender individuals do, in fact, report higher rates of mental illness (Reisner et al, 2014, 2016) than cisgender individuals (Kessler et al, 2005), most plausibly explained by their disproportionate exposure to stigma-related stress (White Hughto et al, 2015). However, some healthcare providers conflated transgender identity itself with mental illness, often as some form of a personality disorder or as a consequence of prior trauma or psychosis.…”

Section: Resultsmentioning

confidence: 99%

“What's the right thing to do?” Correctional healthcare providers' knowledge, attitudes and experiences caring for transgender inmates

Clark

Hughto

Pachankis

2017

Social Science & Medicine

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Rational Incarcerated transgender individuals may need to access physical and mental health services to meet their general and gender-affirming (e.g., hormones, surgery) medical needs while incarcerated. Objective This study sought to examine correctional healthcare providers’ knowledge of, attitudes toward, and experiences providing care to transgender inmates. Method In 2016, 20 correctional healthcare providers (e.g., physicians, social workers, psychologists, mental health counselors) from New England participated in in-depth, semi-structured interviews examining their experiences caring for transgender inmates. The interview guide drew on healthcare-related interviews with recently incarcerated transgender women and key informant interviews with correctional healthcare providers and administrators. Data were analyzed using a modified grounded theory framework and thematic analysis. Results Findings revealed that transgender inmates do not consistently receive adequate or gender-affirming care while incarcerated. Factors at the structural level (i.e., lack of training, restrictive healthcare policies, limited budget, and an unsupportive prison culture); interpersonal level (i.e., custody staff bias); and individual level (i.e., lack of transgender cultural and clinical competence) impede correctional healthcare providers’ ability to provide gender-affirming care to transgender patients. These factors result in negative health consequences for incarcerated transgender patients. Conclusions Results call for transgender-specific healthcare policy changes and the implementation of transgender competency trainings for both correctional healthcare providers and custody staff (e.g., officers, lieutenants, wardens).

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Psychiatric Diagnoses and Comorbidities in a Diverse, Multicity Cohort of Young Transgender Women

Cited by 126 publications

References 45 publications

Prevalence and Correlates of Suicidal Ideation Among Transgender Youth in California: Findings From a Representative, Population-Based Sample of High School Students

Prevalence and Correlates of Suicidal Ideation Among Transgender Youth in California: Findings From a Representative, Population-Based Sample of High School Students

Alcohol research with transgender populations: A systematic review and recommendations to strengthen future studies

“What's the right thing to do?” Correctional healthcare providers' knowledge, attitudes and experiences caring for transgender inmates

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